Health-related needs of survivors of hypertensive disorders of pregnancy: implications for health communication interventions.

BACKGROUND: Hypertensive disorders of pregnancy (HDP) are key contributors to maternal morbidity, mortality, and future risk of cardiovascular disease. This exploratory study aimed to unearth the health-related needs of women with a reported history of HDP by inquiring about preferences for care. METHOD: Deductive, qualitative analysis was conducted of HDP survivors' retrospective 'wishes' about the care received. RESULTS: In analyzing 244 open-ended, online survey responses, we identified a taxonomy of health-related needs arising across the trajectory of HDP: clinical information, needs requiring clinical knowledge, such as information about the etiology or prognosis of HDP; medical, needs associated with HDP intervention and management; logistical, needs regarding practical information, such as how to contact a provider or obtain the correct medical device; emotional, needs involving a desire for support or validation; and communication, needs for improved explanations and recognition of HDP. CONCLUSIONS: A taxonomy of diverse health-related needs may assist clinicians in approaching HDP patients more holistically. Additionally, opportunities exist for health communication research to inform standard approaches to HDP-related communication flowing from provider to patient.

Health Communication in the Time of COVID-19 Pandemic: A Qualitative Analysis of Italian Advertisements.

In the climate of great uncertainty characterizing the COVID-19 pandemic, health communication played a significant role: several communicative strategies and channels were used to inform, educate and alert. Entropy-related risks were soon translated into the "infodemic", a wide-spread phenomenon with psychosocial and cultural roots. Therefore, new challenges for public institutions occurred: public health communication, especially expressed through advertising and audiovisual spots, was engaged to offer key support in combatting the disease, mitigating its effects and supporting health and psychological wellbeing. This work aims to investigate how the Italian public institutions addressed those challenges by employing institutional spots. We tried to answer two main research questions: (a) in line with the literature concerning persuasive communication, what were the main variables that social advertising concerning health attitudes and behaviors relied on; and (b) how the different variables were combined to propose specific communicative pathways following both the different waves/phases of the COVID-19 pandemic and the elaboration likelihood model. To answer these questions, 34 Italian spots were analyzed by means of qualitative multimodal analysis (including scopes, major narratives themes, central and peripheral cues). The results enabled us to individuate different communicative pathways, oriented by inclusivity, functionality and contamination, in line with different rounds as well as with the holistic configurations of cultural narratives, central and peripheral cues.

How WhatsApp is transforming health communication among frontline health workers: a mixed-method study among midwives in India.

BACKGROUND: Limited literature exists in India on WhatsApp use for health communication among frontline health workers like Auxiliary Nurse Midwives (ANM). We conducted this study to assess the adoption of WhatsApp among ANMs and identify factors influencing its adoption. In addition, the study explored the perceptions of ANMs on WhatsApp use for sharing health information. METHODS: We employed a mixed-method sequential explanatory design. We surveyed 259 ANMs, followed by in-depth interviews with 19 purposively sampled ANMs. We conducted multinomial logistic regression to identify factors associated with WhatsApp adoption and employed thematic analysis to analyze interviews. RESULTS: 257 ANMs responded to the survey questionnaire, of which 18.3%, 48.2%, and 33.5% had low, mid, and high levels of WhatsApp adoption, respectively. Education (AOR = 2.87 [95% CI = 1.20-6.85]), motivation (AOR = 6.31 [95% CI = 1.43-27.80]), and technical awareness (AOR = 2.91 [95% CI = 1.11-7.62]) were significantly associated with WhatsApp adoption. Thematic analysis of the interviews resulted in six themes describing perceptions and experiences of ANMs on WhatsApp use. They are: (i) a way of instant communication, (ii) provision for multimedia messaging, (iii) a quick fix tool for queries and concerns, (iv) make attendance and reporting easy (v) a way of reaching higher officials, and (vi) a cost-saving mechanism. CONCLUSION: WhatsApp facilitated ANMs' communication and service delivery at the grassroots level. Measures to improve motivation, technical awareness, and digital education will likely improve WhatsApp adoption among health workers.

An analytic hierarchy process analysis for reinforcing doctor-patient communication.

BACKGROUND: As the health paradigm shifts toward patient-centeredness, patients can actively participate in their own treatment. However, there is still a unilateral aspect of doctor-patient communication, so it is necessary to specify obstacles between doctors and patients. Therefore, this study attempted to extract obstacles that block doctor-patient communication and to analyze differences in perception of doctor-patient communication. METHODS: A total of 35 questionnaires composed of brainstorming for the study were distributed, and a total of 21 questionnaires were used for analysis. The collected data was analyzed by AHP using dress ver 17.0. RESULTS: As a result of the study, doctors ranked the priority of health communication in the order of professionalism, reliability, fairness, communication, and psychologically. On the other hand, for patients, the priority factors of health communication were communication, fairness, professionalism, reliability, and psychologically. CONCLUSION: In order to improve the quality of health communication between doctors and patients, doctors will be able to communicate from the patient's point of view and strengthen communication with patients by providing consistent medical services and patients need to trust the doctor and patients need to trust their doctors and participate in the medical process faithfully.

Mapping Uncharted Terrain: A Systematic Review of Complementary and Integrative Health Communication Using Observational Data in Biomedical Settings.

Complementary and integrative health (CIH) use is diverse and highly prevalent worldwide. Prior research of CIH communication in biomedical encounters address safety, efficacy, symptom management, and overall wellness. Observational methods are rarely used to study CIH communication and avoid recall bias, preserve ecological validity, and contextualize situated clinical communication. Following PRISMA guidelines, we systematically reviewed studies at the intersection of social scientific observational research and findings about CIH communication between clinicians, patients, and caregivers in biomedical settings. We identified international, peer-reviewed publications from seven databases between January 2010 and December 2020. Titles and abstracts were first screened for inclusion, then full studies were coded using explicit criteria. We used a standard checklist was modified to assess article quality. Ten of 11,793 studies examined CIH communication using observational methods for CIH communication in biomedical settings. Studies used a range of observational techniques, including participant and non-participant observation, which includes digital audio or video recordings. Results generated two broad sets of findings, one focused on methodological insights and another on CIH communication. Despite methodological and topic similarities, included studies addressed CIH communication as a process and as proximal and intermediate health outcomes. We recommend how observational studies of CIH communication can better highlight relationships between communication processes and health outcomes. Current research using observational methods offers an incomplete picture of CIH communication in biomedical settings. Future studies should standardize how observational techniques are reported to enhance consistency and comparability within and across biomedical settings to improve comparability.

Harnessing an Integrated Health Communication (IHC) Framework for Campaigns: A Case of Prescription Drug Decision Making.

Drawing on a multiplicity of mass media and health behavior theories, we propose an integrated health communication (IHC) framework to understand and leverage the ways in which mass mediated and interpersonal sources of health information influence the public's health behavior in the context of their prescription drug decisions. Building on the agenda setting theory, two-step flow theory, and the Health Belief Model, we dig into the interrelationships between mass media and interpersonal information sources and information seeking engagement. Employing survey methodology, our framework was tested using a sample of U.S. adults (N = 628). The major results include (a) information gained through interpersonal sources and perceived benefits of the prescription drugs positively and sequentially mediate the association between mass media exposure and intent to seek prescription drug information, (b) interpersonal health information positively moderate the mediation of mass media exposure - perceived benefits - intent to seek prescription drug information, and (c) the inexpert interpersonal information's positive interaction effect with mass media exposure on intent to seek prescription drug information mediated through perceived benefits was greater with high expert interpersonal communication. These results impart valuable theoretical contributions and have the potential to guide integrated health communication (IHC) campaigns.

Educação permanente no sistema único de saúde: concepções de profissionais da gestão e dos serviços / Continuing permanent education in the brazilian national health system: conceptions from management and care professionals / Educación continua en el sistema único de salud brasileño: concepciones de los profesionales de gestión y servicios

Este artigo pretende compreender as concepções de profissionais da gestão e dos serviços do Sistema Único de Saúde (SUS) sobre Educação Permanente em Saúde (EPS), bem como seus desafios e potencialidades. Utilizou-se de grupo focal para coleta, seguido de análise lexical do tipo classificação hierárquica descendente com auxílio do software Iramuteq. Os resultados delinearam quatro classes: a) EPS - entendimentos e expectativas; b) entraves à EPS; c) ETSUS e EPS por meio de cursos e capacitações; e d) dispositivos de EPS: potencialidades e desafios. Os participantes apontaram equívocos de entendimentos acerca da EPS ao equipará-la à Educação Continuada (EC) voltada à transferência de conteúdo, com repercussões negativas na prática de EPS. Discute-se o risco em centralizar o responsável pela concretização dessa proposta, que deveria ser coletiva e compartilhada entre diferentes atores. Reivindica-se, portanto, uma produção colaborativa, que possa circular entre os envolvidos, de modo que cada um experimente esse lugar e se aproprie da complexidade de interações propiciadas pela Educação Permanente em Saúde.(AU)

This article aims to understand the conceptions of professionals from the management and services of the Unified Health System (SUS) on Permanent Education in Health (EPS), as well as its challenges and potential. A focus group was used for data collection, followed by a lexical analysis of the descending hierarchical classification type using the Iramuteq software. The results delineated four classes: a) EPS - understandings and expectations; b) obstacles to EPS; c) ETSUS and EPS by courses and training; and d) EPS devices: potentialities and challenges. Participants pointed out misunderstandings about EPS, when equating it with Continuing Education (CE) focused on content transfer, with negative repercussions on EPS practice. The risk of centralizing the person responsible for implementing this proposal, which should be collective and shared among different actors, is discussed. Therefore, a collaborative production is claimed for, which can circulate among those involved, so that each one experiences this place and appropriates the complexity of interactions provided by Permanent Education in Health.(AU)

Este artículo tiene por objetivo comprender las concepciones de los profesionales de la gestión y servicios del Sistema Único de Salud (SUS) sobre Educación Continua en Salud (EPS), así como sus desafíos y potencialidades. Se utilizó un grupo focal para la recolección de datos, seguido por un análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Iramuteq. Los resultados delinearon cuatro clases: a) EPS: entendimientos y expectativas, b) Barreras para EPS, c) ETSUS y EPS a través de cursos y capacitación, y d) Dispositivos EPS: potencialidades y desafíos. Los participantes informaron que existen malentendidos sobre EPS al equipararla a Educación Continua, con repercusiones negativas en la práctica de EPS, orientada a la transferencia de contenidos. Se discute el riesgo de elegir a un solo organismo como responsable de implementar esta propuesta colectiva, que debería ser colectiva y compartida entre los diferentes actores. Se aboga por un liderazgo colaborativo, que pueda circular entre los involucrados, para que cada uno experimente este lugar y se apropie de la complejidad de interacciones que brinda la Educación Continua en Salud.(AU)

Comunicación terapéutica y terapia narrativa: aplicaciones en el cuidado de enfermería / Therapeutic communication and narrative therapy: applications in nursing care / Comunicação terapêutica e terapia narrativa: aplicações no cuidado de enfermagem

Introducción: La comunicación terapéutica y la terapia narrativa permiten establecer una relación empática con la persona a quien se brinda cuidado, además de atender las necesidades en salud y mejorar su calidad de vida. Metodología: Se realizó una revisión narrativa de la literatura, utilizando bases de datos como Scielo, Pubmed, Proquest, Lilacs, Redalyc y Google Scholar, mediante la búsqueda de las palabras clave "patient care" and "narrative therapy" and "attention" and "nurse-patient relations". Se seleccionaron 50 artículos correspondientes a los últimos 15 años y se realizó análisis y síntesis crítica. Resultados: Las características de la comunicación terapéutica son la escucha activa, compresión, empatía, observación y humanización, al considerar las emociones y experiencias de la persona; su aplicación en el cuidado de Enfermería permite identificar los roles entre la persona y el enfermero. La terapia narrativa comprende la comunicación verbal y no verbal, lo cual facilita la relación entre la persona y el enfermero. La teoría interpersonal de Hildegard Peplau potencializa estas aplicaciones al enfocarse en las relaciones interpersonales terapéuticas. Conclusiones: Las aplicaciones de la comunicación terapéutica y terapia narrativa en el cuidado por enfermería comprenden la orientación, identificación, aprovechamiento y resolución para un abordaje holístico del individuo y su familia.

Introduction: Therapeutic communication and narrative therapy allow establishing an em-pathic relationship with the person to whom care is provided, in addition to meeting health needs and improving their quality of life. Methodology: A narrative review of the litera-ture was carried out, using databases such as Scielo, Pubmed, Proquest, Lilacs, Redalyc and Google Scholar, by searching for the keywords "patient care" and "narrative therapy" and "attention" and "nurse-patient relations". Fifty articles corresponding to the last 15 years were selected and critical analysis and synthesis were performed. Results: The characteristics of therapeutic communication are active listening, understanding, empathy, observation and hu-manization, by considering the person's emotions and experiences; its application in nursing care allows identifying the roles between the person and the nurse. Narrative therapy involves verbal and nonverbal communication, which facilitates the relationship between the person and the nurse. Hildegard Peplau's interpersonal theory potentiates these applications by focus-ing on therapeutic interpersonal relationships. Conclusions: The applications of therapeutic communication and narrative therapy in nursing care comprise orientation, identification, utili-zation and resolution for a holistic approach to the individual and his or her family.

Introdução: A comunicação terapêutica e a terapia narrativa permitem estabelecer uma relação empática com a pessoa a quem se presta o cuidado, além de atender às necessidades de saúde e melhorar sua qualidade de vida. Metodologia: Foi realizada uma revisão narrativa da literatura usando bancos de dados como Scielo, Pubmed, Proquest, Lilacs, Redalyc e Google Scholar, pesquisando as palavras-chave "patient care" e "narrative therapy" e "attention" e "nurse-patient relations". Foram selecionados 50 artigos dos últimos 15 anos e foram realizadas uma análise crítica e uma síntese. Resultados: As características da comunicação terapêutica são a escuta ativa, a compreensão, a empatia, a observação e a humanização, considerando as emoções e as experiências da pessoa; sua aplicação na assistência de enfermagem permite identificar os papéis entre a pessoa e o enfermeiro. A terapia narrativa envolve comunicação verbal e não verbal, o que facilita o relacionamento entre a pessoa e o enfermeiro. A teoria interpessoal de Hildegard Peplau potencializa essas aplicações ao se concentrar nas relações interpessoais terapêuticas. Conclusões: As aplicações da comunicação terapêutica e da terapia narrativa no cuidado de en-fermagem compreendem a orientação, a identificação, o aproveitamento e a resolução para uma abordagem holística do indivíduo e de sua família

What Drives the Influence of Health Science Communication Accounts on TikTok? A Fuzzy-Set Qualitative Comparative Analysis.

Medical institutions face a variety of challenges as they seek to enhance their reputation and increase the influence of their social media accounts. Becoming a social media influencer in the health field in today's complex online environment requires integrated social and technical systems. However, rather than holistically investigating the mechanism of account influence, studies have focused on a narrow subset of social and technical conditions that drive online influence. We attribute this to the mismatch between complex causality problems and traditional symmetric regression methods. In this study, we adopted an asymmetric configurational perspective that allowed us to test a causally complex model of the conditions that create strong and not-strong account influence. We used fuzzy-set qualitative comparative analysis (fsQCA) to detect the effects of varying configurations of three social system characteristics (i.e., an oncology-related attribute, a public attribute, and comment interaction) and two technical system characteristics (i.e., telepresence and video collection) on the TikTok accounts of 63 elderly Chinese doctors (60 to 92 years old). Our results revealed two pathways associated with distinct sociotechnical configurations to strong account influence and three pathways associated with distinct sociotechnical configurations to not-strong account influence. Furthermore, the results confirmed that a single antecedent condition cannot, on its own, produce an outcome, i.e., account influence. Multiple inter-related conditions are required to produce an influential account. These results offer a more holistic picture of how health science communication accounts operate and reconcile the scattered results in the literature. We also demonstrate how configurational theory and methods can be used to analyze the complexities of social media platforms.

Fostering Interdisciplinary Boundary Spanning in Health Communication: A Call for a Paradigm Shift.

Scholarship in the field of health communication is broad, with interdisciplinary contributions from researchers trained in a variety of fields including communication, nursing, medicine, pharmacy, public health, and social work. In this paper, we explore the role of "health communication boundary spanners" (HCBS), individuals whose scholarly work and academic appointment reflect dual citizenship in both the communication discipline and the health professions or public health. Using a process of critical reflective inquiry, we elucidate opportunities and challenges associated with HCBS across the spectrum of health communication in order to provide guidance for individuals pursuing boundary spanning roles and those who supervise and mentor them. This dual citizen role suggests that HCBS have unique skills, identities, perspectives, and practices that contribute new ways of being and knowing that transcend traditional disciplinary boundaries. The health communication field is evolving in response to the need to address significant healthcare and policy problems. No one discipline has the ability to single-handedly fix our current healthcare systems. Narrative data from this study illustrate the importance of seeing HCBS work beyond simply being informed by disciplinary knowledge. Rather, we suggest that adapting ways of knowing and definitions of expertise is an integral part of the solution to solving persistent health problems.

Implementing health communication tools at scale: mobile audio messaging and paper-based job aids for front-line workers providing community health education to mothers in Bihar, India.

INTRODUCTION: As part of an investment by the Bill & Melinda Gates Foundation to support the Government of Bihar to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) statewide, BBC Media Action implemented multiple communication tools to support front-line worker (FLW) outreach. We analyse the impacts of a package of mHealth audio messaging and paper-based job aids used by FLWs during government-sponsored village health, sanitation and nutrition days (VHSNDs) on knowledge and practices of childbearing women across the RMNCHN continuum of care. METHODS: Data from two surveys collected between July and September 2016 were analysed using logistic regression to compare health-related knowledge and behaviours between women who had been exposed at VHSNDs to the mHealth GupShup Potli (GSP) audio recordings or interpersonal communication (IPC) tools versus those who were unexposed. RESULTS: Exposure to GSP recordings (n=2608) was associated with improved knowledge across all continuum-of-care domains, as well as improved health-related behaviours in some domains. The odds of having taken iron-folic acid (IFA) tablets were significantly higher in exposed women (OR 1.5, 95% CI 1.1 to 2.2), as was contraceptive use (OR 2.0, 95% CI 1.2 to 3.2). There were no differences in birth preparedness or complementary feeding practices between groups. Exposure to IPC paper-based tools (n=2002) was associated with a twofold increased odds of IFA consumption (OR 2.3, 95% CI 1.7 to 3.2) and contraceptive use (OR 1.8, 95% CI 1.2 to 2.8). Women exposed to both tools were generally at least twice as likely to subsequently discuss the messages with others. CONCLUSION: BBC Media Action's mHealth audio messaging job aids and paper-based IPC tools were associated with improved knowledge and practices of women who were exposed to them across multiple domains, suggesting their important potential for improving health outcomes for beneficiaries at scale in low-resource settings. TRIAL REGISTRATION NUMBER: NCT02726230.

Experiências de saúde entre mulheres: reflexões a partir de um programa de rádio comunitária / Women's health experiences: reflections from a community radio program / Experiencias de salud entre mujeres: reflexiones a partir de un programa de radio comunitaria

A pesquisa teve como objetivo identificar aspectos da relação das mulheres consigo mesmas, com o processo de saúde-doença e com o Serviço Integrado de Saúde (SIS), unidade de saúde do Sistema Único de Saúde (SUS) que trabalha com Práticas Integrativas e Complementares em Saúde (PICS). O material de estudo analisou entrevistas do programa 'Mulheres do SIS', veiculadas por uma Rádio Comunitária local. A avaliação do conteúdo do material indica particularidades no modo como as mulheres se apresentam e referem suas experiências no campo da saúde. Usam seu nome e condição laboral para se apresentarem, não utilizando outros marcadores sociais. As PICS são reconhecidas pelas mulheres como práticas significativas de cuidado pela atenção às singularidades e aos coletivos. A fala-escuta das experiências das mulheres, possibilitada pelo programa de rádio, contribui para legitimar suas existências, historicamente silenciadas.

This research aimed to identify aspects of women's relationship with themselves, with the health-disease process and with the Integrative Healthcare Service (SIS), healthcare unit of the Unified Health System (SUS) that works with Integrative and Complementary Health Practices (PICS). The study was based on women's interviews collected and broadcasted by a local Community Radio during the show called 'Women of SIS'. The content analysis of the material indicates particularities in the way women present themselves and talk about their experiences in the health field. They present themselves by name and working condition, not using other social markers to talk about themselves. Women recognize the PICS as important care practices that offer attention to singularities and to the collective. The act of speaking/listening about women's experiences, made possible by the radio show, contributes to legitimize their existences, existences that are historically silenced.

La investigación tuvo como objetivo identificar aspectos de la relación de las mujeres consigo mismas, con el proceso de salud-enfermedad y con el Servicio Integrado de Salud (SIS), unidad de salud del Sistema Único de Salud (SUS) que trabaja con las denominadas Prácticas Integrativas y Complementarias en Salud (PICS). El material del estudio consistió en entrevistas con mujeres que transitaron por lo programa 'Mujeres de SIS', de una Radio Comunitaria local. El análisis de contenido del material muestra las particularidades en la forma en que las mujeres se presentan y refieren sus experiencias en el campo de la salud. Se presentan por nombre y condición laboral; no usan otros marcadores sociales para hablar de sí mismas. Las PICS son reconocidas por las mujeres como prácticas de cuidado significativas debido a la atención a las singularidades y lo colectivo. La escucha del discurso de las vivencias de las mujeres, posibilitada por el programa de radio, contribuye a legitimar sus existencias, históricamente silenciadas.

Countering demand for ineffective health remedies: Do consumers respond to risks, lack of benefits, or both?

OBJECTIVE: We tested whether targeting the illusion of causality and/or misperceptions about health risks had the potential to reduce consumer demand for an ineffective health remedy (multivitamin supplements). DESIGN: We adopted a 2 (contingency information: no/yes) × 2 (fear appeal: no/yes) factorial design, with willingness-to-pay as the dependent variable. The contingency information specified, in table format, the number of people reporting a benefit vs. no benefit from both multivitamins and placebo, plus a causal explanation for lack of efficacy over placebo. The fear appeal involved a summary of clinical-trial results that indicated multivitamins can cause health harms. The control condition received only irrelevant information. MAIN OUTCOME MEASURE: Experimental auctions measured people's willingness-to-pay for multivitamins. Experiment 1 (N = 260) elicited hypothetical willingness-to-pay online. Experiment 2 (N = 207) elicited incentivised willingness-to-pay in the laboratory. RESULTS: Compared to a control group, we found independent effects of contingency information (-22%) and the fear appeal (-32%) on willingness-to-pay. The combination of both interventions had the greatest impact (-50%) on willingness-to-pay. CONCLUSION: We found evidence that consumer choices are influenced by both perceptions of efficacy and risk. The combination of both elements can provide additive effects that appear superior to either approach alone.

When Social Media Images and Messages Don't Match: Attention to Text versus Imagery to Effectively Convey Safety Information on Social Media.

Health organizations can use visuals that support observational learning in social media. The social cognitive theory construct of observational learning illustrates how social media messages can inform health-related behavior change. In a within-subjects design, parents (n = 150) were exposed to real-world social media posts where safety recommendation text and imagery was matched (n = 3) or unmatched (n = 3). Safety topics were relevant to children age seven and younger: infant sleep, poisoning prevention, and bicycling safety. Eye tracking software captured visual attention (in milliseconds) on visual imagery and a post-experiment survey recorded correct answers to safety recommendations. Analyses examined the relationship between the match between text and imagery and visual attention. Participants spent more time on the matched image posts compared to mismatched image posts (5.3 versus 3.3 seconds; p < .001). After accounting for frequency of social media use and health literacy, each second of viewing time on the matched posts was associated with a 2.8% increase in the correct response safety information knowledge score (p < .001). Matched text and visuals on social media posts attracted significantly higher visual attention and improved safety knowledge.

A comparison of health communication effectiveness and the improvement of management strategies: taking two Chinese traditional medicine hospitals' WeChat public accounts as examples.

BACKGROUND: In the light of "Internet plus", hospitals are following the trend of using mobile internet and adopting a strategy of spreading public health knowledge through mobile terminals. WeChat is a social media with the largest number of users in China. Its public account has become the most popular service among the public. METHODS: We examine the health communication of medical institutions on social media platforms. The WeChat public accounts of Zhejiang Provincial Chinese Traditional Medicine Hospital and Jiangxi Provincial Chinese Traditional Medicine Hospital were taken as cases to measure the communication effect from the following dimensions: update interval, content positioning and design, numbers of clicks and likes as well as topic types. RESULTS: The update interval of WeChat public account of Jiangxi Provincial Hospital of Traditional Chinese Medicine was regular, compared with that of the other hospital. The accounts of the two hospitals both set up special sections to facilitate patients to obtain medical services online. There is an extremely significant difference between the two hospitals' mean numbers of clicks (p < 0. 001), compared with no significant difference between their mean numbers of likes. One-way analysis of variance suggests the type of topic on posts is significantly correlated with the number of clicks. Moreover, there is an extremely significant difference between public health knowledge and news propaganda. CONCLUSION: The development of hospitals' WeChat public accounts can promote people's health and equity in accessing medical information and service, and also boost "Internet plus health care" service. The topic type of hospital's news publicity is paid a relatively lower attention by users. Therefore, hospitals' WeChat public accounts need to adjust their strategy from propaganda-oriented to users-centered, with topic planning and posts designed to fulfill users' needs.

Territórios do cuidar: comunicação e memória nas medicinas dos povos tradicionais afro-brasileiros / Health care territories: communication and memory in the practice of medicine by traditional Afro-Brazilian people / Territorios del cuidar: comunicación y memoria de la medicina de los pueblos tradicionales afro-brasileños

O presente artigo aborda a cultura e a medicina dos povos tradicionais afro-brasileiros como determinantes sociais da saúde em diferentes grupos étnicos, suas relações existentes com processos comunicativos e a efetivação de políticas públicas, especialmente a denominada Política Nacional de Práticas Integrativas em Saúde e Complementares no Sistema Único de Saúde, assim como o campo da educação patrimonial em saúde. A partir das análises de narrativas do projeto na área de comunicação e saúde por meio das linguagens das artes, realizado na Fundação Oswaldo Cruz entre 2004 e 2008, em articulação com as questões da tese de doutorado sobre as memórias da diversidade sociocultural dos povos tradicionais em suas artes de cura na Jurema Sagrada, em desenvolvimento na Pós-Graduação em Memória Social da Universidade Federal do Rio de Janeiro, este texto indica pontos importantes acerca dos processos de comunicação na educação em saúde mediante o mapeamento dos territórios do saber como estratégias de memórias e resistências de grupos étnicos.

This article examines both culture and medicine practice by the traditional Afro-Brazilian people as health social determinants in different ethnic groups, their relations with communicative processes and the implementation of public policies, specially the Política Nacional de Práticas Integrativas em Saúde e Complementares no SUS (National policy of integrative and complementary health practice by SUS), and the field of heritage of health education. It is based on the narrative analysis of the project developed by Fundação Oswaldo Cruz (Fiocruz) from 2004 to 2008 in the communication and health area by means of art languages, related to issues proposed on PhD thesis about memories of the cultural and social diversity revealed by traditional people in its cure arts in Jurema Sagrada, in phase of development through the Programa de Pós-Graduação em Memória Social (Postgraduate program in social memory at Unirio - Universidade Federal do Rio de Janeiro. This text points out important issues about communication processes in health education through mapping of knowledge territories as strategies for memory and resistance of ethnic groups.

Este artículo analiza la cultura y la medicina de los pueblos tradicionales afro-brasileños como determinantes sociales de la salud en diferentes grupos étnicos, sus relaciones existentes con procesos comunicativos y la implementación de políticas públicas, especialmente la Política Nacional de Práticas Integrativas em Saúde e Complementares no SUS (Política nacional de prácticas integrales y complentarias de salud en el SUS) y el campo de la educación patrimonial de la salud. Él se basa en el análisis de narrativas del proyecto en comunicación y salud a través de los lenguajes de las artes, realizado en la Fundação Oswaldo Cruz (Fiocruz) en el periodo de 2004 hasta 2008, relacionado con las cuestiones de tesis doctoral sobre las memorias de la diversidad sociocultural de pueblos tradicionales revelada en sus artes curativas en Jurema Sagrada, en desarrollo en el Programa de Pós-Graduação em Memória Social (Programa de posgrado en memoria social) de la Universidade Federal do Rio de Janeiro (Unirio). El presente texto apunta cuestiones importantes sobre los procesos de comunicación en la educación en salud a través de la esquematización de los territorios del saber como estrategias de memorias e resistencia de los grupos étnicos.

Mindfulness, promoção da saúde e semiótica: bases para modelos comunicacionais em saúde online / Mindfulness, health promotion, and semiotics: Bases for communication models in online health / Mindfulness, promoción de la salud e semiótica: bases para modelos de comunicación en salud em línea

OBJETIVO: identificar como o texto verbo-visual do curso produz sentidos e como isso pode auxiliar na construção do design de outros cursos. MÉTODO: foi feita a análise semiótica de duas práticas e de um print de tela do curso denominado Programa de Autocuidado Baseado em Mindfulness, na modalidade Educação à Distância, desenvolvido pelo Centro Brasileiro de Mindfulness e Promoção da Saúde ("Mente Aberta"), do Departamento de Medicina Preventiva da Universidade Federal de São Paulo. Foram avaliados os elementos estéticos que contribuiriam para a construção de um ambiente de prática eufórico (ligado à saúde) e estabelecidas relações entre o plano de conteúdo e o plano de expressão das práticas, responsáveis pela construção de um sistema semissimbólico. RESULTADOS: confirmou-se a valorização de uma estética da simplicidade de cores e formas que converge para uma afirmação dos valores calma e bem-estar compatíveis com as práticas de mindfulness. CONCLUSÃO: a partir dessa análise, busca-se refletir sobre as bases para o desenvolvimento de modelos comunicacionais relacionados à promoção da saúde em ambiente digital.

OBJECTIVE: to analyze an online course on health promotion based on mindfulness (mindfulness) through the theory of discursive semiotics in one of its most recent developments, the visual or plastic aspect. The objective is to identify how the verbal-visual text of the course produces meanings and how it can help in the design of other courses. METHOD: a semiotic analysis of two practices and a screen print of the course called Mindfulness-Based Self-Care Program, in distance learning, developed by the Brazilian Center for Mindfulness and Health Promotion ("Open Mind"), of the Department of Preventive Medicine at the Federal University of São Paulo. RESULTS: the aesthetic elements that contributed to the construction of an euphoric practice environment (linked to health) were evaluated and relationships were established between the content plan and the practice expression plan, responsible for the construction of a semi-symbolic system. CONCLUSION: it was confirmed the appreciation of an aesthetics of simplicity of colors and shapes that was converged to an affirmation of the values ​​of calm and well-being compatible with the practices of mindfulness. From this analysis, we seek to reflect on the bases for the development of communicational models related to health promotion in a digital environment.

OBJETIVO: analizar un curso en línea sobre promoción de la salud basado en la atención plena (mindfulness) a través de la teoría de la semiótica discursiva en uno de sus desarrollos más recientes, el aspecto visual o plástico. El objetivo es identificar cómo el texto verbal-visual del curso produce significados y cómo puede ayudar en el diseño de otros cursos. MÉTODO: se llevó a cabo un análisis semiótico de dos prácticas y una impresión de pantalla del curso llamado Programa de autocuidado basado en la atención plena, en educación a distancia, desarrollado por el Centro Brasileño de Mindfulness y Promoción de la Salud ("Mente Abierta"), del Departamento de Medicina Preventivade de la Universidad Federal de São Paulo. RESULTADOS: se evaluaron los elementos estéticos que contribuyeron a la construcción de un entorno de práctica eufórica (vinculado a la salud) y se establecieron relaciones entre el plan de contenido y el plan de expresión de práctica, responsables de la construcción de relaciones semi-simbólicas. CONCLUSIÓN: se confirmó la valoración de una estética de simplicidad de colores y formas, que convergió en una afirmación de los valores de calma y bienestar compatibles con las prácticas de mindfulness. A partir de este análisis, buscamos reflexionar sobre las bases para el desarrollo de modelos comunicacionales relacionados con la promoción de la salud en un entorno digital.

CKDNET, a quality improvement project for prevention and reduction of chronic kidney disease in the Northeast Thailand.

BACKGROUND: The incidence of chronic kidney disease (CKD) is high in the Northeast Thailand compared to other parts of the country. Therefore, a broad program applying all levels of care is inevitable. This paper describes the results of the first year trial of the Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), a quality improvement project collaboratively established to curb CKD. METHODS: We have covered general population, high risk persons and all stages of CKD patients with expansive strategies such as early screening, effective CKD registry, prevention and CKD comprehensive care models including cost effectiveness analysis. RESULTS: The preliminary results from CKD screening in general population of two rural sub-districts show that 26.8% of the screened population has CKD and 28.9% of CKD patients are of unknown etiology. We have established the CKD registry that has enlisted a total of 10.4 million individuals till date, of which 0.13 million are confirmed to have CKD. Pamphlets, posters, brochures and other media of 94 different types in the total number of 478,450 has been distributed for CKD education and awareness at the community level. A CKD guideline that suits for local situation has been formulated to deal the problem effectively and improve care. Moreover, our multidisciplinary intervention and self-management supports were effective in improving glomerular filtration rate (49.57 versus 46.23 ml/min/1.73 m2; p < 0.05), blood pressure (129.6/76.1 versus 135.8/83.6 mmHg) and quality of life of CKD patients included in the program compared to those of the patients under conventional care. The cost effectiveness analysis revealed that lifetime cost for the comprehensive health services under the CKDNET program was 486,898 Baht compared to that of the usual care of 479,386 Baht, resulting in an incremental-cost effectiveness ratio of 18,702 Baht per quality-adjusted life years gained. CONCLUSION: CKDNET, a quality improvement project of the holistic approach is currently applying to the population in the Northeast Thailand which will facilitate curtailing of CKD burden in the region.

Integrating the social sciences into the COVID-19 response in Alberta, Canada.

This paper outlines the rapid integration of social scientists into a Canadian province's COVID-19 response. We describe the motivating theory, deployment and initial outcomes of our team of Organisational Sociologist ethnographers, Human Factors experts and Infection Prevention and Control clinicians focused on understanding and improving Alberta's responsiveness to the pandemic. Specifically, that interdisciplinary team is working alongside acute and primary care personnel, as well as public health leaders to deliver 'situated interventions' that flow from studying communications, interpretations and implementations across responding organisations. Acting in real time, the team is providing critical insights on policy communication and implementation to targeted members of the health system. Using our rapid and ongoing deployment as a case study of social science techniques applied to a pandemic, we describe how other health systems might leverage social science to improve their preparations and communications.